Oftentimes "ketosis" is stigmatized. Ketosis is talked about by many as being dangerous and unhealthy.

But, I was wondering, has anyone read anything about the level of ketosis experienced by, say, the all-too-normal calorie counting woman. Say she is restricting herself to 1200 cal. a day. To make this meal work, it often includes:

I sincerely tried calorie counting, and I remember this was the main diet of most women on the forum. Of course this is called "clean eating" and is seen as the healthiest diet ever by these women (who knows... maybe it is)

Most restrict their carbs severely, though unconsciously. They know that a gram of bread has 4 x's the amount of calories than vegetables and lean protein. All of them try to get the "biggest bang for their buck". Of course, the biggest talk in these forums revolves around binging and insurmountable cravings.

Despite their avoidance of fat, I would have to think that they are often in a mild ketosis state (burning fat their own fat!). I mean, isn't this the goal? Or is there some other way their fat is burned??

If this is the case, why isn't the "dangerous state of ketosis" discussed amongst them?

It just seems like the word "ketosis" has acquired a very negative connotation. But doesn't anyone who is actively losing weight experience some sort of ketosis (body using its fat as fuel)?

Similar to how the word "fat", especially eating fat, has become synonymous with bodily fat; it is thus something to be avoided if being fat is to be avoided ..... if we had a different word for dietary "fat" in our culture, I do often wonder if there would have never of been a low-fat craze.

Someone help me clarify this - I read the wiki site on Ketosis, but it doesn't go into the role ketosis plays in "conventional weight loss". If conventional weight loss never brings about any state of ketosis, how is body fat burned?

Well I am no expert, but from what I understand ketosis just means burning fat as fuel and for some people, any diet that restricts calories will cause ketosis. Most people experience ketosis during exercise or at night, especially in the absence of carbohydrates.

People who do LC/HF diets to lose bodyfat, are usually people that have a metabolic imbalance that causes a malady in fat storage. In other words their body is programmed to store fat so when calories (nutrients) come in, instead of them being made available to the tissues and cells that need them, the body redirects these nutrients into fat cells and stores them. This causes hunger and as a result causes the individual to overeat. That is how some people become fat while others can remain thin, roughly eating the same types of foods.

People that don't have this metabolic issue can lose weight on a conventional diet like the one you described because when they restrict calories their body won't take some of these calories and place them into storage first. Their body will use them and if necessary will burn any extra body fat when they go into ketosis. That is a normal metabolic process.

In the case of the metabolically impaired individual when they restrict calories with a diet that is protein/carb based (ie. low fat). The body takes these incoming nutrients and starts storing them first. This is because carbs induce insulin release, so the body goes into storage mode and facilitates the storing process, at the same time inhibits the release of fat and ketosis. The blood sugar level then drops. From what I understand this is where this person will run into problems, because in a normal person, the body will then start releasing fatty acids to provide the person with fat for fuel and ketosis will occur. However in a person who is metabolically impaired the body doesn't do this. When the blood sugar is low, their fat cells do not give up their storage fat as easily and the person experiences mild hypoglycemia, this causes hunger and then the person eats to get the nutrients they need. The cycle then repeats itself, leading to more and more fat deposition over time. Because basically the person is always experiencing starvation due to the fact that their adipose cells seem resistant to releasing their storage fat for ketosis for when the body experiences low blood sugar.

For some people the only way around this is to prevent insulin release by decreasing carbs. And in some cases the amount of protein as well.

That is a fabulous question and I have pondered this one as well. I think that people flit in and out of ketosis all the time when 'dieting' and even when not but are sick or simply needing to go without food fuel for any length of time. The maximum requirement for ketosis is about 50g of carbs (for some) and that could be easily done without knowing it in a low calorie regiment.

__________________Cathy
Original start - Feb. 2000 180/125

"The energy content of food (calories) matters, but it is less important than the metabolic effect of food on our body." Dr. P. Attia

Punkin thanks for the awesome answer - I appreciate you typing it up. I am definitely of the type that can't seem to use incoming calories for energy, unless I'm on a high fat diet. I know this by the fatigue I feel after eating even a piece of fruit - which, didn't you post that you feel the best in the morning before you ever eat? I feel that way too. For many of us, serotonin levels are adversely affected when we eat - which can lead to worse moods (see The Scribble Pad's latest post!)

Yet, I still need the piece of fruit/veggie/starch at some point (I also don't seem to be suited for deep ketosis), so it doesn't seem to have the fatigue affect if I eat it after an intense workout or before bed (before bed, so I don't notice the fatigue, I'm already asleep when it hits).

I know I feel this way because of my childhood morbid obesity. Punkin, why do you think you do? Was it the overexercising? I did just read an abstract for the article 'Human Growth Hormone and Ketosis in Athletes and Non-athletes', which showed that athletes tend to produce many less ketones after a workout than non-athletes.

Anyway, back to the topic of "ketosis": I found a general definition of ketosis in an article dating 1963, 'Hormonal Aspects of Ketosis' (seems to be an early study of ketosis, pointing to its negative effects):

"Ketosis is defined here as a state in which ketone bodies accumulate in the extracellular fluid in concentrations greater than during conditions of carbohydrate plenty [...] It is generally a physiological phenomenon, reflecting those alterations in metabolism that normally accompany a shift from carbohydrate to fat metabolism [...] Reduced to its simplest terms, ketosis may be expected to develop whenever the availablity of carbohydrate in the metabolic mixture is relatively or absolutely deficient in relation to the amount of fat being catabolized."

It is clear that this definition of ketosis - when one does not have "carbohydrate plenty" - does include most women calorie counters, who avoid things like bread and potatoes due to their having a higher calorie per gram. A calorie counting program is ALWAYS seen as healthy by conventional health care workers.

And remember the fashionable "long-term calorie restriction", which apparently leads to longevity? I would have to bet that many of them visit "ketosis" (the evil killer) often, everyday.

In my opinion, much of this can be traced to the fact that the word "fat" has been stigmatized in all its uses. This is sort of changing as many are trying to discuss "healthy fats". I'm convinced that if we had another word besides fat to explain "dietary fat", it wouldn't be so intertwined with the fat on our bodies (people would not think "eating fat makes you fat").

People are afraid of the "fat" on their bodies, thus they have an irrational fear of all "fat".

Anyway - this post is just me working through much criticism to "ketosis" in general. I am worried about my health in the future, and would never want to promote a diet on the internet if it were dangerous. However, this diet makes my life worth living after a long history of obesity, intermittent periods of bulimia/anorexia, and depression (which are actually common problems for the majority of women in America). Oh, and I used to smoke - I would grab a cigarette to battle the overwhelming hunger... I didn't know how to control it otherwise.

Btw, something interesting to note: Did you know that the diet most of us follow here is very, very similar to the best diet for Crohn's patients? They are encouraged to stay away from fruit, wheat, and anything else with high carb counts. They are also told to eat more meat, eggs, yogurt, broths, and fats.

I know I feel this way because of my childhood morbid obesity. Punkin, why do you think you do? Was it the overexercising? I did just read an abstract for the article 'Human Growth Hormone and Ketosis in Athletes and Non-athletes', which showed that athletes tend to produce many less ketones after a workout than non-athletes.
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I think ketosis is a normal part of human metabolism. I'm not sure why they would elude it to dangerous side effects. Ketosis just means the burning of fatty acids for fuels. Unless they mean it is dangerous to be in a state of ketosis when absolutely 0 carbs are available. Which I think is impossible. The only diet I can think of that would do that is pure oil/fat. And who would be living off that? Because even if you are eating meat, you can still convert protein to glucose, so you wouldn't be completely carbohydrate free.

I am currently reading Gary Taubes books: Why we get fat and Good calories, bad calories and looking for the answers to the questions about exercise. Apparently my experiences seem to match what the research says about exercise; it doesn't make you thinner, it makes you fatter! So using it to try to manage your weight is futile. I found that out on my own, so I didn't need to be told that that would happen. I noticed it over time. I had to keep upping the amount I was doing to keep away the fat. Even if you restrict your calories he says, your body will just burn your lean muscle mass to make up the difference in calories. There was one compelling study where they tracked a group of people training for marathons year after year. And they found that the people who ran the most (had the most weekly mileage) were indeed the thinnest people, but as a group, they were getting fatter and fatter every year. Its one of the reasons we buy into the exercise myth; because it seems like the people doing the most exercise are the leanest but what we don't see is that their leanness has to do with their genetics. Lean people also get fatter over time when exercise and it shows up over time through a change in body composition; more body fat, less muscle.

Since I still need to lose about 5lbs, I definitely don't want to do something that will make me fatter

What I don't know yet, but I haven't finished reading the books, as to why that happens. What I suspect is related to what you said. That athletes burn less ketones after exercise. I think it has to do more with when you "stop" exercising. During exercise you are in ketosis, ie burning fat. Which is a catabolic effect. There is no insulin, instead the other hormones are acting on your fat cells to get them to give up their fatty acids for fuel. But then when the exercise is over, your body switches to the anabolic state. Your body basically goes the other way and stimulates the fat cells to start storing fat again for your next workout. He discusses this in the book. I think the more you exercise, the more your body gets efficient at making this switch. But I think there is a bit more to it than that. Because I think the body actually "overshoots" this fat storage process. It doesn't just replace the fat lost through exercise I think it overstocks on fat. I haven't finished the book so I think the answer will be revealed by the time I am finished.

I notice with myself that I am hungry after exercise and on rest days I overeat. He talks about why this happens. He says the hunger is a result of my body taking the incoming calories and storing them directly as fat, before the cells in my body have a chance to use them as fuel. It causes cellular starvation, even though I am not starving and creates more hunger.

I tried an experiment yesterday to see if I could experience a day with a difficult workout with no hunger. I went out and skied 17K which for me was about a 2.5 hr workout. When I got home I ate a VLC/VLP high fat meal equaling about 200cal. Then I ate what I normally would. So far, no hunger. Today I am taking the day off. Day offs are sometimes the days when I experience hypoglycemia. My day is going to be low carb/low protein and high fat. If I don't experience any hypoglycemia or hunger then I am pretty convinced that Gary is correct in his theories. Which means that if you are going to exercise to lose fat, your diet has to be VLC and maybe even low protein, which seems to be the case for me.

He also says in the book that some people have more of an affinity for getting fat than others. This is because some people seem to have fat tissue that is hungrier for storing fat than other people. So he says your genetics seem to program you for becoming fat. I haven't gotten to the point of where he says what we can do about that yet. But I suspect the answer he is getting to has to do with keeping your insulin levels down, because insulin seems to be the fat storing hormone. Insulin is triggered by the presence of carbs so he is probably going to extoll the virtues of the LC diet. But I think there is more to it than that, because in the case of exercise, insulin is almost non-existent in the bloodstream during exercise. So why you be hungry after exercise? There is obviously something else at work in the case of exercise, that explains why exercise causes over-eating. I know it is because the fat tissues want to be restocked from their lost fuel, but it doesn't make sense because if you have many extra pounds of body fat, which most people do, why are the fat cells insisting on collecting more?

That is the next question that needs to be answered for sure, maybe he'll write more books.

I read Gary Taube's book a while back, and I seem to recall that he does advocate exercise, but for overall health, not to lose weight. Please correct me if I'm wrong! Personally I find that I don't have an appetite after exercise.

Most I know who eat low-calorie diets comprise them of things like fruits, veggies (including starchy ones), beans, whole grains, etc. They may flirt with ketosis, but I'd bet a good 50% or more of their calories still come from carbohydrates.

__________________Weight goals currently on hold due to pregnancy...baby #2 coming late October/early November 2013!

The reason I wrote the original post is because I keep running across a good deal of "ketosis criticism", dealing all the way from elevated triglycerides to kidney stones. Funny thing is, this diet is used to treat Crohn's and other intestinal diseases; it is seen as healthy.

Many question Taubes' insulin hypothesis. But from my own self-experimentation, it really seems true. Also, the lack of continual insulin flooding my body has also regulated by mentrual cycle and my moods.

I agree with you regarding too much protein - I think my body also became used to easily converting protein, which explains why the simple "primal" diet worked well at first, but then stopped working quite so well..... I simply needed to add more fat and cut the protein back.

But protein isn't simply protein, for example: many can eat larger portions of fish and not experience the same gluc. reaction as other forms of animal protein, such as chicken.

Punkin: Can you give me an idea of what you eat after your 2.5 hour workout? I'm just curious.

jillybean720: When I was on the calorie counting forums for support, it was a lot of women eating skinless chicken breasts and broccolli! If they did eat bread, it was low-carb. They would eat grapes, but they would freeze the grapes then savor a few very slowly everyday, hardly enough to bring up the carb level substantially. Poor women - week after week of brutal dieting and barely ever any results.

eek. I was one of those. Glad to no longer be in that vicious cycle! (and Punkin thanks for explaining Taubes' work on why calorie restriction often leads to decreased muscle mass!)

heh, we must talk to different groups of low-cal dieters Those I see eating chicken breast and broccoli also have it with brown rice. Bread was fine, as long as it's the low-calorie kind (35-45 calories per slice, but they're still usually 10-12g carbs, I believe). Gotta have those heart-healthy whole grains and such!

__________________Weight goals currently on hold due to pregnancy...baby #2 coming late October/early November 2013!

Keep in mind that blood ketones are probably being produced to feed glucose-burning cells that can also burn ketone bodies (mainly betahydroxybutyrate, BHB, and aceto-acetate, AcAc) but will not burn triglycerides. Muscles, for instance, burn triglycerides fine. However nervous tissue (like your brain) cannot. There just happens to be a quick home-test for blood ketones, whereas you need a lab to test your blood fatty acids.

By the way, high blood triglyceride levels are often associated with a high carb diet. For instance, prior to my switching to a low carb diet my blood triglycerides were measured at 192. After about 3 months of low carb, they had dropped to 68.

The reason that some people (including doctors) demonize measurable blood ketone levels is that in our carb-fueled society about the only time they see them are during cases of diabetic ketoacidosis (DKA). DKA is bad, because it actually alters your blood pH and your body does not tolerate changes in blood pH well. BHB and AcAc are both acids.

That said, they seem not to be an issue below 8mM or so. Non-diabetic people have no difficulty regulating their levels to prevent this from becoming an issue.

Punkin: Can you give me an idea of what you eat after your 2.5 hour workout? I'm just curious.

After reading the blurb in Gary's book about exercise I was really concerned about feeding my body ANYTHING that might trigger an insulin release. So I took a really LC veggie salad (bok choy leaves removed, plus alfalfa sprouts) and drowned it in a high fat dressing made from 3 tbsn Heavy cream, 1.5 tsp dijon mustard, 1/8 tsp salt and fresh pepper. I also threw in some chopped chives into the salad. It had roughly 2.5g of net carbs in it and I had no reaction.

Funny thing about the protein. I seem to react to the leaner meats unless I drown them in fatty sauces. I used to eat a lot of egg whites, but now if I eat egg whites I get a reaction to them which leads to severe hypoglycemia. And yet, I have no reaction to eating a whole egg. It could either be because the whole egg either has the fat, or is more difficult to convert to glucose than the whites. Who knows which one it is, all I know is that I can't seem to be able to handle them.

Interesting question. I sometimes wonder if the urine stick results vary so much because the ketones are being used up by the body.
But on the conventional diet question, I read Covert Bailey's "Smart Exercise" several years ago. I hope someone knowledeable will comment on this.
He said that in an aerobic state, fat was burned completely with carbs in the Krebs Cycle. Without carbs, the krebs cycle no longer worked and the fat was only partially burned, and (the dreaded) ketones were produced. In an anaerobic state, only sugar is being burned.

Interesting question. I sometimes wonder if the urine stick results vary so much because the ketones are being used up by the body.

Yes, that is why. Also as your body becomes more adapted to the ketogenic state, less acetoacetate (the ketone measured by the stix) is excreted.

Quote:

Originally Posted by Liz1959

But on the conventional diet question, I read Covert Bailey's "Smart Exercise" several years ago. I hope someone knowledeable will comment on this.
He said that in an aerobic state, fat was burned completely with carbs in the Krebs Cycle.

Sure, either are metabolized. Well carbs go through glycolysis first, but their metabolic products end up in the Krebs Cycle afterwards.

Quote:

Originally Posted by Liz1959

Without carbs, the krebs cycle no longer worked and the fat was only partially burned, and (the dreaded) ketones were produced.

That is almost certainly wrong. Ketones are burned by the Krebs cycle, so how is it no longer working? Ketones are probably produced to feed cells that don't use fatty acids but can use ketones -- for example, nervous tissue, including the brain.